Promising Treatment Approach for Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder (PMDD) causes mental symptoms such as irritability and depression. The progesterone receptor modulator primarily reduces the mental symptoms of PMDD, according to a new study. The findings of the study are published in the journal The American Journal of Psychiatry. The mental symptoms of premenstrual dysphoric disorder improve following treatment with a progesterone receptor modulator, as demonstrated by SciLifeLab researcher Erika Comasco and Professor Inger Sundström-Poromaa, Uppsala University. The study drug's mechanism of action provides insights into the potential molecular mechanisms underlying this psychiatric disorder and its treatment.

It has long been known that the menstrual cycle can affect women's mood and well-being. This manifests itself in mild symptoms that do not need any treatment for most women of reproductive age. Still, for 3-5 percent of women, the hormonal changes during the menstrual cycle lead to disabling mental symptoms: premenstrual dysphoric disorder (PMDD).

Selective progesterone receptor modulators bind to and inhibit progesterone receptors in the brain. This is a relatively new class of drugs developed for the treatment of uterine fibroids and endometriosis. In this multicentre, double-blind, placebo-controlled clinical trial, researchers from Uppsala University, Karolinska Institutet, and Umeå University, all in Sweden, have demonstrated for the first time the efficacy of a selective progesterone receptor modulator as a treatment for PMDD.

Half of the women (50 percent) receiving the treatment improved completely, while the corresponding proportion of women receiving placebo was 21 percent.

"Side effects were mild, and the ongoing development of well-tolerated progesterone receptor modulators will hopefully make this a treatment option for patients with PMDD," says Professor Inger Sundström-Poromaa of the Department of Women's and Children's Health and the Centre for Women's Mental Health during the Reproductive Lifespan (WoMHeR) at Uppsala University.

Looking ahead, the researchers are currently investigating how progesterone receptor modulator affects the brain in women with PMDD. By neuroimaging these patients' brains before and during treatment, using magnetic resonance imaging, the researchers aim to define structural and functional brain signatures that can explain the relief of PMDD symptoms.

The research results will be an important piece of the puzzle of improving our understanding of PMDD mechanisms, the researchers say. Today, the first-line treatment for PMDD is serotonin reuptake inhibitors. Although these drugs are very effective, they are not suitable for all women, and additional treatment options are valuable. In addition, it would be desirable to have a treatment that more specifically addresses the mechanisms underlying this psychiatric disorder.

Source-Eurekalert